Landrieu urges Medicaid vote

Promoting it as a health care and economic issue, U.S. Sen. Mary Landrieu pushed Tuesday for Louisiana voters to decide the fate of Medicaid expansion.

“The governor has clearly put his political future ahead of the future of the state of Louisiana,” said Landrieu, D-La. “Let the people decide what is fair, whether they want to expand and use over $16 billion” in federal funds.

“It’s kind of our last hope to let the people make the decision. It’s not too much to ask,” Landrieu said.

Medicaid is the federal health insurance program for the poor. The federal Affordable Care Act contains a provision under which the federal government would pay 100 percent of the cost to expand Medicaid the first three years and no less than 90 percent in the ensuing years. The U.S. Supreme Court said states had the option of whether to participate.

Gov. Bobby Jindal has rejected the Medicaid expansion, which would cover residents whose incomes are at or below 138 percent of the federal poverty level. For an individual, it is $15,856 and for a family of four $32,499. Jindal claims it would cost the state too much money long-term and it builds on a broken federal health care system.

Landrieu led a conference call with state Sen. Ben Nevers, D-Bogalusa, and state Rep. Patricia Smith, D-Baton Rouge, sponsors of proposed constitutional amendments that would provide nearly 250,000 mainly working adults with health insurance coverage.

Nevers said his Senate Bill 96 would be heard next week in the Senate Health and Welfare Committee. The proposed constitutional amendment would direct the state Department of Health and Hospitals, effective Jan. 1, to administer a state program providing access to health insurance to legal residents whose income is at or below 138 percent of the federal poverty level. The proposition would be submitted to voters Nov. 4, if it wins approval by a two-thirds vote of the Senate and House.

Landrieu said the proposition makes good economic sense. “In order to have a strong workforce, you need a healthy workforce,” she said. She said the state is rejecting $16 billion available “to strengthen the workforce.”

The Medicaid expansion also would bring 15,600 new health care-related jobs in 2016 and help sustain financially struggling rural hospitals, Landrieu said.

Nevers and Smith said the climate has changed in the year since the last push for Medicaid expansion died in the Legislature. They each said the precarious budget Jindal submitted, potential loss of $307 million in federal funds associated with LSU public-private partnership deals and community hospitals not getting reimbursed for the thousands showing up in emergency rooms is putting more pressure on.

A lot of the pressure would be relieved with adoption of Medicaid expansion, Nevers said.

“We have a very serious situation coming down not only with this budget but the next budget,” Smith said.

“I truly believe the Legislature is going to have to consider this. We are in a dire strait,” Nevers added.

Former state health chief David Hood, who participated in the call, said the federal government picks up 93 percent of the costs on average over a ten-year period. He said it is the most favorable federal match rate Louisiana has ever seen.

While Jindal calls Medicaid a broken system, Hood reminded how Louisiana successfully participated in Medicaid’s Children’s Health Insurance Program expansion. “We covered more than 400,000 children during the Foster administration. … We have done it before and we certainly can do it again,” he said. “The Medicaid expansion we have already done is very successful.”